Jericho High School Teacher Evaluation Form
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1Jericho High School Teacher Evaluation Form
99 Cedar Swamp Road
Jericho, NY 11753
(516) 203-3600
______________________________________________________________________________________________________________________________________
To The Applicant
Fill in the information below and give it to a teacher who has taught you an academic subject.
Provide the teacher with stamped envelopes addressed to each of the colleges requesting a Teacher Evaluation.
Birthdate _______________
Gender _______________
mm/dd/yy
Student Name _______________________________________________________________________
Last
First
Middle (complete)
Address ____________________________________________________________________________
Number and Street
City
State
Zip
School you now attend – Jericho High School
CEEB/ACT code – 332628
I waive access to this recommendation which shall therefore be considered confidential.
____________________________________________________________ __________________
Student Signature
Date
________________________________________________________________________
To The Teacher
Teacher’s Name (please print or type)
Position
Note to Schools: All information regarding the teacher’s length of acquaintance with the student, the subjects taught to the student
and student achievement in the course is addressed in the attached letter.
1. What do you know of this student’s intellectual qualities? What are your impressions of the student’s academic priorities? Can you
give any evidence about the nature of his/her motivation for academic work? Consider the originality, independence and sensitivity
he/she displays in course work and the breadth of intellectual interests. How are the expressions of verbal and written ideas? What is
the quality of his/her performance as compared to classmates?
See Attached.
2. Which personal qualities stand out in the applicant? In addition, are there any features of the applicant’s background that would be
important for a college to know? Consider personal strengths and weaknesses.
See Attached.
3. Do you have any reason to doubt this student’s academic integrity?
No_______
Yes _______
4. In terms of your _____ years of experience, how would you compare this applicant to his/her entire class?
Not
Below
Good
Excellent
Outstanding
Top
Applicable
Average
Average
above Average
top 10%
top 5%
1 %
Academic
Achievement:
_______
________
_______
______
_______
_______
______
Academic
Potential:
_______
_______
_______
_______
_______
_______
_______
Character/
_______
________
_______
______
_______
_______
_______
Personal Qualities:
Overall Rating:
_______
________
_______
______
_______
_______
_______
Teacher Recommendation Letter Attached
Signature _________________________________________________________Date _______________
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